Mehmet Kaygın, Nail Kahraman, Ümit Halıcı, Özgür Dağ, Hüsnü Limandal, Ümit Arslan, Eyüp Çalık, Bilgehan Erkut

İZOLE VENA SAFENA PARVA STRİPİNGİ SONRASINDA KOMPRESYON ÇORAPLARININ ETKİNLİĞİ: RETROSPEKTİF ÇALIŞMA

Amaç: Bu çalışmanın amacı, izole Vena SafenaParva stripingi sonrasında orta basınçlı elastikkompresyon çorabı kullanılmasının etkinliğiniaraştırmaktır.Gereç ve Yöntem: 2011 Ocak ile 2014 Marttarihleri arası izole Vena Safena Parva yetmezliğinedeniyle opere edilen 60 hasta (40 kadın, 20 erkek,yaş ortalaması; 39± 11, 35-58 yaş arası) burandomize kontrollü retrospektif çalışmaya dahiledildi. Ekstremitelere postoperatif 3 gün boyuncaelastik bandaj uygulandı. Hastalar ilaveten 4haftalık kompresyon çorabı giyenler (Grup 1; 18kadın, 12 erkek, yaş ortalaması 35±12,2, 23-47 yaşarası] ve giymeyenler (Grup 2; 22 kadın, 8 erkek,yaş ortalaması 38±10.8, 27-49 yaş arası.) olmaküzere iki gruba ayrıldı. Primer sonlanım vesekonder sonlanım sonuçları değerlendirildi.Bulgular: Çalışma ve kontrol grubunda bacakortalama hacimleri sırasıyla preoperatif 4600±540ve 4740 ± 420 ml iken postoperatif 4. hafta sonunda4440±430 ml ve 4660 ± 400 ml’e geriledi. Dörthaftalık takip döneminde işe dönüş,komplikasyonlar açısından fark gözlenmedi. Bacakhacimleri ve vizuel analog skala ağrı skorlarındagrup 1’de istatistiki olarak anlamlı derecede birazalma saptandı.Sonuç: İzole vena safena parva stripingi sonrasıilave elastik kompresyon çorabı giyilmesiekstremite ödemi ve postoperatif ağrı hissindeanlamlı derecede azalma sağlayabilir. Diğer taraftanvaris çorabı kullananlar ile kullanmayanlarkomplikasyon gelişimi ve işe dönüş zamanıaçısından benzer görünmektedir.

Anahtar Kelimeler:

Vena safena parva, striping, komplikasyon, skleroterapi

Effectiveness of Compression Stockings After Isolated Vena Saphena Parva Stripping: A Retrospective Study

Background: The objective of this study is to investigate the effectiveness of medium pressurized elastic compression stockings usage after isolated vena saphena parva stripping. Material and Methods: Between 2001 January2014 March, 60 patients (40 women, 20 men, mean age; 39± 11 years, 35 to 58 years range) treated with vena saphena parva ligation and total stripping for isolated vena saphena parva insufficiency, were enrolled in this retrospective study. Elastic bandage applied postoperatively. Patients were divided into two groups according to use of additional compression stocking for 4 weeks; as stockings using group, (group 1; 18 women, 12 men, mean age 35±12.2, 23 to 47 years) and as no stockings using group, (group 2; 22 women, 8 men, mean age 38±10.8, 27 to 49 years) and. Primary outcomes and secondary outcomes were evaluated. Results: Extremity volumes in Group 1 and Group 2 were reduced from preoperatively 4600±540 ml and 4740 ± 420 ml to postoperatively 4440±430 ml and 4660 ± 400 ml, respectively. There were no differences between two groups by means of time to return to work and complications. Extremity volumes and Visual Analogue Scale pain scores were detected statistically significant reduction at the end of 4 weeks in group 1. Conclusion: Additional use of compression stockings after isolated vena saphena parva stripping can provide significant reduction in extremity edema and visual analog scale pain score. On the other hand, developing complications and time to return to work in both groups seem similar

Keywords:

Vena Saphena Parva, Stripping, Complication, sclerotherapy,

PDF

___

Houtermans-Auckel JP, Van Rossum E, Teijink JAW, Dahlmans AAHR, Eussen EFB,
S.P.A. Nicola SPA ve ark. Variköz Venlerin Çıkarılması Sonrasında Kompresyon
Çoraplarının Giyilmesi veya Giyilmemesi: Randomize Kontrollü Bir Çalışma Eur J Vasc
Endovasc Surg 2009; 2:173-178.
Özkan A, Kin İşler A. Sporcularda Bacak Hacmi, Kütlesi, Hamstring/ Quadriceps Oranı ile
Anaerobik Performans ve İzokinetik Bacak Kuvveti Arasındaki İlişki. Hacettepe J of Sport
Sciences 2010; 21:90–102.
Sukul, DK, Den Hoed, KS, Johannes, EJ, Van Dolder R, Benda, E. Direct and indirect
methods for the quantification of leg volume: comparison between water displacement
volumetry, disk model method and the frustum sign model method, using the correlation
coefficient and the limits of agreement, Journal of Biomedical England. 1993;15:477-480,
Doran FS, Barkat S. The management of recurrent varicose veins. Ann R Coll Surg Engl
; 63:432-436.
Creton D. Hypothe`ses e´tiologiques des re´cidives variqueuses saphe`ne interne: e´tude
anatomique sur 211 cas. In: Negus D, Jantet G, Collerıdge-Smıth Pd, eds. Phlebology 1995.
London: Springer-Verlag, 164-168.
Creton D. 125 reinterventions for recurrent popliteal varicose veins after excision of the
short saphenous vein. Anatomical and physiological hypotheses of the mechanism of
recurrence. J Mal Vasc 1999; 24:30-37.
Kurdal AT, Cerrahoglu M, İskesen İ, Kahraman N, Eserdag M., Ozbakkaoglu A ve ark.
Vena Safena Parva Ligasyonuyla Beraber Stripping Yapılmalı mı? İ. Ü Kardiyol Enst Derg
;8: 17-21
C. Allegra, P.L. Antignani and A. Carlizza Recurrent Varicose Veins Following Surgical
Treatment: Our Experience with Five Years Follow-up, Eur J Vasc Endovasc Surg 2007;33,
-756
Jones L, Braithwaite BD, Selwyn D, Cooke S, Earnshaw JJ. Neovascularisation is the
principal cause of varicose vein recurrence: results of a andomised trial of stripping the long
saphenous vein. Eur J Vasc Endovasc Surg 1996; 12:442–445.
Van Bemmelen PS, Bedford G, Beach K, Strandness DE Jr: Quantitavive segmental
evaluation of venous valvular reflux with ultrasound scanning. J Vasc Surg 1989; 10:425-431.
Biswas S, Clark A, Shields DA. Randomised clinical trial of the duration of compression
therapy after varicose vein surgery. Eur J Vasc Endovasc Surg 2007;33: 631-7.
Raraty MGT, Greaney MG, Blair SD. There is no benefit from weeks postoperative
compression after varicose vein surgery: a prospective randomized trial. Phlebology 1999;
:21-5.
Rodrigus I, Bleyn J. For how long do we have to advise elastic support after varicose vein
surgery? A prospective randomized study. Phlebology; 1991;6: 95-98.
Shouler PJ, Runchman PC. Varicose veins: optimum compression after surgery and
sclerotherapy. Ann R Coll Surg Engl 1989;71:402-4.
Bass A, Chayen D, Weinmann EE and Ziss M. Lateral venous ulcer and short vein
insufficiency saphenous. J Vasc Surg 1997;25:654-7.
Theivacumar NS, Beale RJ, Mavor AID and Gough MJ. Initial Experience in Endovenous
Laser Ablation (EVLA) of Varicose Veins Due to Small Saphenous Vein Reflux Eur J Vasc
Endovasc Surg 2007; 33, 614-618.